PTSD Acute vs Chronic: What’s the Difference?

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Read Time: 6 Minutes
Written by:Bisma Anwar, MA, MSc, LMHC

Published On: January 30, 2023

Medically reviewed by: Jill E. Daino, LCSW-R

Reviewed On: January 30, 2023

Updated On: October 31, 2023


When you get a PTSD diagnosis, you could also be diagnosed with acute or chronic PTSD, two types of post-traumatic stress disorder. Acute stress disorder (ASD) and chronic post-traumatic stress disorder (PTSD) are both conditions triggered by trauma. Though they both are the result of trauma, there are some differences between the two conditions that are important to know about. Primarily, acute stress disorder describes symptoms that appear in the immediate aftermath of a traumatic event and resolve after a specific time. Chronic PTSD, though, refers to symptoms that persist for a month or more.

Read on to learn more about the factors that separate post-traumatic stress disorder acute vs chronic.

What Is Acute Stress Disorder?

Acute stress disorder is an anxiety condition that people can develop shortly after a traumatic experience. Signs of acute stress disorder include flashbacks, nightmares, and dissociative episodes.

Although you’ll find similarities when comparing acute PTSD vs chronic PTSD symptoms, a major differentiator is how long symptoms last. ASD symptoms will last for at least 3 days but not longer than 1 month.

What Is Chronic PTSD?

The word “chronic” refers to something that keeps recurring or has persisted over a long period. Chronic PTSD is an ongoing condition after a shocking or distressing event. Symptoms of chronic PTSD are the same as ASD, but can last for months or even years.

When is PTSD considered chronic?

While PTSD symptoms can appear immediately after a traumatic event, the diagnostic criteria in the DSM-5 specify that the disturbances must continue for 1 month or more. Essentially, this means that someone who’s diagnosed with acute stress disorder could be diagnosed with PTSD at a later date.

Acute Stress Disorder vs Chronic PTSD

There are differences between ASD and chronic PTSD, including the range of symptoms experienced and how long they last. In addition, risk factors and treatments for each condition may also vary.


When you compare PTSD acute vs chronic symptoms, you’ll see a significant overlap. Avoidance, hyperarousal, and flashbacks are common symptoms in both conditions. However, acute stress disorder is more strongly associated with dissociative symptoms.

Another critical difference between the two conditions is the duration of symptoms. Acute stress disorder symptoms can continue anywhere from 3 days to 4 weeks. Chronic PTSD symptoms, though, must continue for at least 1 month and potentially persist for years.


Mental health providers diagnose conditions by gathering information about symptoms. This information helps make an accurate PTSD chronic vs acute stress disorder diagnosis. While it’s true that the conditions do share some signs, there are clear differences in the diagnostic criteria.

Acute stress disorder

ASD is diagnosed when someone has had direct or indirect exposure to a traumatic event and has experienced at least 9 qualifying symptoms. Again, symptoms must continue for at least 3 days but will resolve by the end of 1 month.

Acute stress disorder symptoms include:

  • Recurring memories of the distressing event
  • Nightmares related to the event
  • Flashbacks of the event
  • A loss of memories related to the event
  • Sleep disturbances
  • Difficulty focusing
  • Making an effort to avoid reminders of the event
  • Attempting to avoid memories or feelings related to the event
  • Experiencing intense stress after being reminded of the event
  • Distortions in the sense of reality, like the feeling that time has slowed down
  • Angry outbursts or irritability
  • Hypervigilance
  • An elevated response to stimuli, such as sudden movements or loud noises

Chronic post-traumatic stress disorder

While it’s not unusual to experience emotions like shock, fear, or increased anxiety after an upsetting event, these feelings usually lessen as time goes on. Chronic PTSD causes people to experience intense feelings over a long period.

PTSD symptoms fall into 4 categories, which are:

  • Re-experiencing: These symptoms cause someone to relive events related to their trauma. Examples of re-experiencing symptoms include nightmares, flashbacks, and intrusive memories and thoughts.
  • Avoidance: Avoiding people, places, or situations that bring up bad memories are all examples of avoidance symptoms. To cope with complex trauma, people with PTSD may also become emotionally numb.
  • Cognitive symptoms: This category refers to adverse changes in a person’s cognition, beliefs, or mood. For example, many people find it challenging to feel happy, or they might begin to have difficulty trusting others after experiencing the traumatic experience.
  • Hyperarousal: Hyperarousal causes you to be on high alert due to intense fear, even if no threat exists. Symptoms include jumpiness, difficulties sleeping or concentrating, and heightened feelings of stress.

To be diagnosed with chronic PTSD, a person must have one or more re-experiencing symptoms, two hyperarousal symptoms, three avoidance symptoms, and three cognitive symptoms. These symptoms must interfere with everyday activities and continue for at least one month.


One of the most notable similarities you’ll encounter when comparing PTSD acute vs chronic is the root causes of each condition’s symptoms. Both chronic PTSD and acute stress disorder occur after someone witnesses or experiences a traumatic event. Events that could trigger these conditions include, but aren’t limited to:

  • The threat of death or serious injury
  • Physical assault
  • Sexual violence
  • Fires
  • Natural disasters
  • Robbery
  • Violent death
  • Unexpected severe illness

What causes someone to develop acute PTSD vs chronic PTSD? It’s important to note that everyone responds to trauma differently. One distressing experience won’t necessarily lead to symptoms of either condition. However, there are certain risk factors associated with both ASD and PTSD.

Comparisons of post-traumatic stress disorder acute vs chronic show that women are more likely to develop either condition. Other factors that put some people at increased risk include repeated exposure to trauma and a lack of social support. Finally, pre-existing mental health conditions, such as anxiety, depression, or bipolar disorder, can elevate risk for chronic PTSD.

iconExpert Insight

“Chronic post-traumatic stress disorder (PTSD) is a severe anxiety disorder resulting from a traumatic event. Acute stress disorder (ASD) is similar in that it’s diagnosed after a traumatic event. Those who meet full ASD criteria have higher chances to develop chronic PTSD if they do not get the right treatment for their symptoms.”
Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar


The treatments used for PTSD chronic vs acute stress disorder are relatively similar. Therapy for PTSD, such as CBT for PTSD, alongside medication for PTSD is considered the most effective option for both conditions. However, short-term treatments are often recommended since ASD is a temporary condition. Chronic PTSD is treated through long-term medication management and therapy.

iconExpert Insight

“Treatment for ASD and chronic PTSD includes therapy and medication management. The sooner an individual engages in treatment, the better their prognosis is. Seeking help sooner rather than later can help them heal from a traumatic event.”
Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

Identifying Which Type of PTSD You Have

If you’re struggling with symptoms after a distressing event, the first step is learning what exactly you’re dealing with. Treatments for post-traumatic stress disorder acute vs chronic can vary. This is why getting an accurate diagnosis from a trained and experienced mental health professional is so essential so you can start healing from PTSD naturally.

At Talkspace Psychiatry, an expert can evaluate your symptoms and provide you with a diagnosis so you can start effective treatment options like learning grounding techniques for PTSD. Whether you’re dealing with PTSD acute vs chronic symptoms, a professional can create a plan and be your support as you recover. Reach out today to find someone who can tell you more about the condition you’re struggling with.

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Bisma Anwar

Bisma Anwar is the Team Lead for the Talkspace Council of Mental Health Experts. A major focus in her work has been anxiety management and helping her clients develop healthy coping skills, reduce stress and prevent burnout. She serves on the board of a non-profit organization based in NYC called The Heal Collective which promotes advocacy and awareness of mental health issues in BIPOC communities.

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